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Late pregnancy thyroid-binding globulin predicts perinatal depression.

Cort Pedersen1, Jane Leserman1, Nacire Garcia1

  • 1Department of Psychiatry, The University of North Carolina at Chapel Hill, CB# 7160, Chapel Hill, NC 27599, United States.

Psychoneuroendocrinology
|January 6, 2016
PubMed
Summary

Thyroid-binding globulin (TBG) and free thyroxine (FT4) levels in early pregnancy may predict perinatal mood disorders. TBG, in particular, showed a strong association with syndromal depression, even when considering trauma and major depression history.

Keywords:
AnxietyMajor depression historyPostpartumPregnancyThyroidTrauma

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Area of Science:

  • Endocrinology
  • Perinatal Psychiatry
  • Reproductive Health

Background:

  • Previous research indicated a negative relationship between late pregnancy thyroxine levels (TT4, FT4) and perinatal depressive symptoms.
  • Thyroid-binding globulin (TBG) increases during pregnancy, potentially indicating sensitivity to estrogen and its mood-destabilizing effects.
  • Understanding predictors of perinatal depression and anxiety is crucial for maternal mental health.

Purpose of the Study:

  • To investigate if thyroid indices (FT4, TBG) measured in early third-trimester pregnancy predict subsequent perinatal depression and anxiety.
  • To assess the predictive value of FT4 and TBG for syndromal depression during the perinatal period.
  • To explore the role of TBG as an index of sensitivity to hormonal changes during pregnancy.

Main Methods:

  • A cohort of 199 euthyroid pregnant women was recruited from a public health obstetrics clinic.
  • Hormone levels (FT4, TBG) were measured at 31-33 weeks of gestation.
  • Participants underwent psychiatric interviews and self/interviewer ratings for depression and anxiety at 35-36 weeks gestation and 6 and 12 weeks postpartum. Life-time trauma and major depression history were also assessed.

Main Results:

  • Trauma and major depression history were robust predictors of depression and anxiety ratings throughout the study.
  • FT4 levels were a significant predictor of depression and anxiety ratings when analyzed alone (p<.05).
  • TBG levels were a significant or nearly significant predictor of most depression and anxiety ratings. In combined models with trauma and major depression history, TBG strongly predicted perinatal syndromal depression (p=.005), while FT4 did not.

Conclusions:

  • Thyroid indices, particularly TBG, may play a role in predicting perinatal depression, especially syndromal depression.
  • Trauma history is a significant predictor of perinatal mood disturbances.
  • Further research into the interactions between TBG, FT4, sex hormones, and trauma history is warranted to understand vulnerability to perinatal mood disorders.